Template-free TiO2 photoanodes for dye-sensitized solar cell via modified chemical route.

Surfactant and template-free Titanium dioxide (TiO2) spheres have been deposited via ultrasonic rinsing assisted modified successive ionic layer adsorption and reaction (M-SILAR) method. The effect of M-SILAR cycle variation on the growth of TiO2 films and power conversion efficiency (PCE) of dye-sensitized solar cells (DSSCs) has been reported. Also, the significant influence of the dye adsorption time of photoelectrodes on the overall PCE of TiO2 based DSSCs has been investigated systematically. The SEM images reveal that the TiO2 microspheres are made up of densely packed and interconnected nanospheres. After dye loading maximum absorption peak around 500nm is seen with broader coverage in the visible region of the solar spectrum. The excess amount of dye for dye loading time 15h did not contribute to current and is suspected to be present either in multilayers or physisorbed on the surface of TiO2. The DSSC prepared using photoelectrode TO125 and dye loading time of 12h exhibited the highest power conversion efficiency (PCE) of 1.16% with short-circuit current density (Jsc) of 8.17mA/cm2, open circuit voltage (Voc) of 0.42V and fill factor of 0.34. The PCE is attributed to the large molecular interconnected TiO2 spheres diffusing visible light to enhance the light absorption. Also, it possesses relatively superior 3-D microsphere like structure and thus provides the effective pathway to the photogenerated electrons with low recombination rate, leading to attaining the high PCE.

Becoming a physician anaesthetist-difficulties encountered for half a century.

William T.G. Morton was not the first to use ether or nitrous oxide as an anaesthetic. However, his public demonstration on 16 October, 1846 (Ether Day), and the notoriety that followed thereafter, are credited for announcing man's victory over surgical pain to the entire world. The use of ether during surgery spread rapidly through most of the world. One would expect that the careers of Ether Day participants would have been greatly affected by this seminal event and that some would go on to become anaesthetists. An examination of the participants' professional lives shows that some became strong advocates of anaesthesia and ether was used extensively for their patients. Some were prolific writers and helped spread the use of anaesthesia. However, attracting physicians to this new discipline proved difficult and there were segments of the medical establishment and society who were unwilling to accept this most significant advancement. In this article, we examine the reasons why many physicians and patients resisted the use of anaesthesia.

Reduction in postoperative endophthalmitis with intracameral cefuroxime.

Postoperative endophthalmitis is an uncommon complication of cataract surgery with grave consequences. This report describes the trend of endophthalmitis in a district general hospital in England over eight years, and attempts made to modify this trend. An outbreak of endophthalmitis in 2007 led to a detailed investigation and subsequent changes in practice. Intracameral cefuroxime (ICC) was introduced in place of subconjunctival cefuroxime. Use of ICC in patients with 'penicillin allergy' was explored, found to be safe and resulted in a change of policy. This led to a four-fold reduction in the rate of endophthalmitis.

Contributions of ancient Indian physicians--implications for modern times.

Ayurveda traces its origins to contributions of mythological and real physicians that lived millennia earlier. In many respects, Western medicine also had similar origins and beliefs, however, the introduction of anatomical dissection and progressive application of scientific evidence based practices have resulted in divergent paths taken by these systems. We examined the lives, careers, and contributions made by nine ancient Indian physicians. Ancient texts, translations of these texts, books, and biographical works were consulted to obtain relevant information, both for Indian traditional medicine as well as for Western medicine. Ayurveda has retained principles enunciated by these physicians, with minor conceptual advances over the centuries. Western medicine separated from ancient Indian medicine several hundred years ago, and remains the foundation of modern medicine. Modern medicine is evidence based, and randomized clinical trials (RCTs) are the gold standard by which efficacy of treatment is evaluated. Ayurvedic medicine has not undergone such critical evaluation to any large extent. The few RCTs that have evaluated alternative medical treatment recently have shown that such therapy is no better than placebo; however, placebo treatment is 30% effective. We suggest that foreign domination, initially by Mughals, and later by the British, may have contributed, in part, to this inertia and protracted status quo.

A semi-centennial report on the participants depicted in Joel Babb's portrait, 'the first successful kidney transplantation'.

Joseph Murray performed the first successful human kidney transplant on December 23, 1954. Forty-three years later, he along with participants Francis Moore and Leroy Vandam, commissioned a painting of the event from artist Joel Babb (1). To document this unique record of medical history, we identify all those present at the operation and depicted in the portrait, describe how the artist created the work, explain irregularities and inaccuracies in the painting, provide a 50-year follow-up on everyone involved, and comment on any influence this landmark event may have had on their subsequent careers.

Pediculosis pubis: presentation to ophthalmologist as pthriasis palpebrarum associated with corneal epithelial keratitis.

Pthiriasis palpebrarum caused by infestation with Pthirus pubis (crab louse) draws attention to pediculosis in the pubic and inguinal region. As pthiriasis is usually transmitted by sexual contact, many cases are likely to have other sexually transmitted diseases. A multidisciplinary approach is essential in the management of these cases. In this case report, we highlight the above and report for the first time associated keratitis.

Unintentional inversion of corneal buttons during penetrating keratoplasty: clinico-pathological report of two cases.

AIM: This report describes the clinico-pathological features of unintentionally inverted corneal buttons in two patients. METHODS: A clinico-pathological report. RESULTS: Two patients who underwent repeat keratoplasty for failed grafts were found to have inverted corneal buttons on histopathological examination. A detailed description of the pathological features of the inverse keratoplasty and the clinical outcome after repeat keratoplasty is presented. CONCLUSION: Inadvertent inverse keratoplasty should be considered as a rare cause of corneal graft failure. The serious complication of anterior chamber epithelialization seems to be unlikely and the prognosis following repeat penetrating keratoplasty appears to be very good.

Spectrum, frequency and penetrance of OPA1 mutations in dominant optic atrophy.

Dominant optic atrophy (DOA) is the commonest form of inherited optic neuropathy. Although heterogeneous, a major locus has been mapped to chromosome 3q28 and the gene responsible, OPA1, was recently identified. We therefore screened a panel of 35 DOA patients for mutations in OPA1. This revealed 14 novel mutations and a further three known mutations, which together accounted for 20 of the 35 families (57%) included in this study. This more than doubles the number of OPA1 mutations reported in the literature, bringing the total to 25. These are predominantly null mutations generating truncated proteins, strongly suggesting that the mechanism underlying DOA is haploinsufficiency. The mutations are largely family-specific, although a common 4 bp deletion in exon 27 (eight different families) and missense mutations in exons 8 (two families) and 9 (two families) have been identified. Haplotype analysis of individuals with the exon 27 2708del(TTAG) mutation suggests that this is a mutation hotspot and not an ancient mutation, thus excluding a major founder effect at the OPA1 locus. The mutation screening in this study also identified a number of asymptomatic individuals with OPA1 mutations. A re-calculation of the penetrance of this disorder within two of our families indicates figures as low as 43 and 62% associated with the 2708del(TTAG) mutation. If haploinsufficiency is the mechanism underlying DOA it is unlikely that this figure will be mutation-specific, indicating that the penetrance in DOA is much lower than the 98% reported previously. To investigate whether Leber's hereditary optic neuropathy (LHON) could be caused by mutations in OPA1 we also screened a panel of 28 LHON patients who tested negatively for the three major LHON mutations. No mutations were identified in any LHON patients, indicating that DOA and LHON are genetically distinct.

Evaluation of a disposable prism for applanation tonometry.

BACKGROUND: Recently the Medical Devices Agency recommended that 'ophthalmic devices that touch the surface of the eye should be restricted to single use'. AIM: To evaluate one such device: a disposable tonometer prism for routine applanation tonometry. METHODS: The intraocular pressure (IOP) of 100 consecutive patients from a general eye clinic (197 eyes) was measured with both a disposable and the standard Goldmann tonometer (Goldmann). The level of agreement between the two methods of clinical measurement was assessed and the sensitivity and specificity of the disposable prism in detecting clinically significant raised IOP estimated. RESULTS: The mean difference in IOP measured by the two different prisms was 0.44 mmHg with a standard deviation (SD) of 1.54. The mean IOP for the disposable prism was 19.51 mmHg (SD 6.53 mmHg). The mean IOP for the standard Goldmann tonometer prism was 19.07 mmHg (SD 6.64 mmHg). The sensitivity to detect IOP > 21 mmHg was 95.9% (95% confidence interval (CI): 86.0-99.5%) and the specificity of 93.9% (95% CI: 88.8-97.2%). It gave a positive predictive value of 83.9% (95% CI: 71.7-92.4%). CONCLUSION: There was close agreement between the IOP measurements obtained by the disposable tonometer prism and the Goldmann device for high and low pressures. If replicated, the high sensitivity and specificity would justify its use in screening.

Is the first post-operative day review necessary following uncomplicated phacoemulsification surgery?

PURPOSE: To assess the necessity for first post-operative day review in determining the need for post-operative intervention in patients who had uncomplicated phacoemulsification surgery. METHODS: A retrospective study was carried out to review the first post-operative day findings in patients who underwent uncomplicated phacoemulsification surgery by a single surgeon between January 1997 and March 1998. The findings analysed were wound integrity, corneal clarity, anterior chamber activity, intraocular pressure and the intraocular lens status. The need for medical or surgical intervention was also analysed. Those eyes that had coexisting ocular pathology such as glaucoma, ocular hypertension, uveitis, trauma or previous intraocular surgery were excluded from the study. Fisher's exact test was used to compare the difference between the groups. RESULTS: Seventy-one eyes of 71 patients who underwent an uncomplicated phacoemulsification procedure were included in the study. Intraocular pressure of 30 mmHg or greater was found in 7 eyes (10%), all of which also had corneal oedema. These patients received acetazolamide SR 250 mg twice daily for 3 days. Another 21 eyes (30%) had corneal oedema for which no specific treatment was given. The intraocular pressure had returned to baseline and corneal oedema resolved by the first clinic follow-up in 1-2 weeks. None of the 71 patients needed surgical intervention in the post-operative period. CONCLUSION: First post-operative day review is necessary as it gives an opportunity to manage the post-operative rise in intraocular pressure.

Group-C meningococcal conjunctivitis in a neonate.

Meningococcal conjunctivitis, although rare, may be complicated by ocular damage and systemic spread. Identification of the infecting organism is important for appropriate management. Meningococcal infection needs treatment of both the patient and the contacts. We report the use of meningococcal group-C vaccine in the prophylaxis of adult contacts of a neonate with meningococcal conjunctivitis. This measure, we believe, has not been reported before in the management of meningococcal conjunctivitis.